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Pharm Flashcards

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1
Q

what is the half life

A

time it takes for plasma concentration or the amount of drug in the body to be reduced by 50%

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2
Q

what drug levels are increased by grapefruit

A

nifedipine
verapamin

statins

midazolam

SSRIs

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3
Q

what drugs prolong qt interval

A

ondansetron

haloperidol

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4
Q

antidote for lead

A

succimer

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5
Q

local anesthetics end in what?

A

-caine

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6
Q

opioids side effects (MORPHINE)

A

miosis

out of it

resp depression

pruritus, pneumonia

hypotension, headache

infrequent elimination

nausea and nervousness

emesis

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7
Q

what kinds of drug is buprenorphine & nalbuphine

A

opioid agonist-antagonist

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8
Q

when would you use buprenorphine

A

mild to moderate pain, opioid addiction

less euphoric effect
less chance of abuse

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9
Q

what kind of drug is naltrexone

A

opioid antagonist

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10
Q

s/s of ASA toxicity (salicylism)

A

tinnitus

sweating

headache

dizziness

metabolic acidosis

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11
Q

when do we give aspirin to kids

A

kawasaki’s disease

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12
Q

what drugs can help lower bp (ABCD)

A

ACE inhibitors and ARBS

beta blockers

CCBs

diuretics

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13
Q

can you take ACEs or ARBS during pregnancy

A

no

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14
Q

what are the nonselective CCBs

A

verapamil and diltiazem

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15
Q

what are the effects of the non selective CCBs

A

cause vasodilation of the blood vessels, increasing coronary perfusion

in the heart - slow HR, slow AV node conduction, decrease force of contraction

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16
Q

what drugs are nifedipine, amlodipine, etc.

A

selective CCBs - only act on blood vessels not the heart!

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17
Q

side effects of selective CCBS?

A

dizziness, edema

gingival hyperplasia

reflex tachy

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18
Q

does hydralazine dilate the veins or arteries

A

arteries

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19
Q

what are the arterial AND venous dilators

A

nitrates (nitroglycerin, nitroprusside)

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20
Q

can you take calcium supplements with CCBs

A

yes! do not need to discontinue

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21
Q

which CCBs can cause constipation

A

nondihyrdos (vera and dil)

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22
Q

what kind of drugs are procainamide and lidocaine

A

sodium channel blockers

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23
Q

what kind of drug is amiodarone

A

K+ channel blocker

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24
Q

when would you use amiodarone

A

V tach if patient is awake and alert

PVCs

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25
Q

AEs of amiodarone

A

Liver, thyroid, pulmonary toxicity

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26
Q

when do you use adenosine

A

SVT

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27
Q

how do you administer adenosine

A

rapid push

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28
Q

what should you expect after adenosine

A

period of asystole
patient will feel like someone kicked them in the chest

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29
Q

MOA of digoxin

A

increases contractility while decreases HR

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30
Q

therapeutic range for digoxin?

A

.5-2

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31
Q

early s/s of digoxin toxicity

A

n/v
anorexia
yellow/green halos in vision

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32
Q

late s/s of digoxin toxicity

A

bradycardia leading to fatal arrythmias

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33
Q

who are at risk for digoxin toxicity

A

hypokalemia
hypomagnesemia
hypercalcemia

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34
Q

digoxin antidote

A

digoxin immune fab

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35
Q

what are inhaled glucocorticoids used for (i.e. budesonide)

A

for asthmatics to take regularly
not for acute attacks!

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36
Q

what are systemic glucocorticoids used for (i.e. methylprednisolone)?

A

acute attacks
best to use <10 days

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37
Q

what kind of drugs is montelukast

A

leukotriene receptor antagonist

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38
Q

when do you take montelukast

A

long term control, cannot abort ongoing attack

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39
Q

SE of montelukast

A

liver injury
neuropsychiatric effects (including SI)
churg-strauss syndrome

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40
Q

what do monoclonal antibodies (like omalizumab) act on

A

IgE –> reduce to decrease inflammatory reaction

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41
Q

how long do you have to monitor someone after monoclonal antiboties

A

2 hours after first 3 doses and 30 mins after all other doses
monitoring for anaphylaxis

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42
Q

examples of long acting beta 2 agonists

A

salmeterol
formoterol

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43
Q

side effects of beta 2 agonists

A

relaxation of smooth muscle in airways
but also tachycardia angina, tremor

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44
Q

what are theophylline and aminophylline used for

A

asthma maintenance

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45
Q

what kind of drug is ipatropium and what is it used for

A

anticholinergic

used for asthma and COPD, can be used for acute attack

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46
Q

what do alpha antagonists end with

A

-osin

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47
Q

when do you use apha antagonists

A

HTN
BPH
raynaud’s
pheochromocytoma

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48
Q

why are beta blockers used in caution with diabetics

A

will mask symptoms of hypoglycemia

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49
Q

which beta blockers are safer for asthmatics and diabetics and why

A

metoprolol, carvedilol, esmolol, labetalol,

because they are beta 1 selective

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50
Q

what do cholinesterase inhibitors end in and what is there effect

A

-stigmine

increase cholinergic effects - rest and digest

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51
Q

who do you avoid cholinergics with

A

intestinal obstruction
uti
asthma
hyperthyroidism
hypotension

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52
Q

do you take cholinergics with food

A

no! take on empty stomach

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53
Q

cholinergic drug side effects (DUMBELS)

A

diaphoresis and diarrhea

urination

miosis

bradycardia, bronchospasm

emesis

lacrimation

salivation

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54
Q

how do you treat muscarinic posioning

A

atropine (anti-cholinergic)

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55
Q

how do anticholinergics like oxybutynin impact urinary system

A

helps with urination retention

you would take oxybutynin for overactive bladder

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56
Q

what it is the antidote for anticholinergic toxicity

A

physostigmine

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57
Q

what kind of drugs are donepezil and rivastigmine

A

cholinesterase inhibitors

help improve symptoms in mild and moderate AD like improving memory and reasoning

58
Q

what is a side effect of phenytoin

A

gingival hyperplasia

59
Q

can you take phenytoin during pregnancy

A

no

60
Q

what are 5 long term anticonvulsants

A

phenytoin
fosphenytoin
carbamazepine
phenobarbital
valproic acid

61
Q

what should you use to abort a seizure

A

lorazepam

diazepam

62
Q

what should you not take with anticonvulsants

A

antacids

63
Q

H2 receptor antagonists MOA

A

block release of stomach acids

64
Q

can you take H2 receptor antagonists with meals

A

yes

65
Q

when should you take PPIs

A

30-60 mins before meals

66
Q

what should you report for PPIs

A

black tarry stools

67
Q

when should you take sucraflate

A

1 hour before meals or 2 hours after and at bedtime

68
Q

what drugs does sucralfate decrease bioavailability of

A

warfarin

digoxin

phenytoin

levothyroxine

separate drugs by at least 2 hours!

69
Q

what kind of drug is bisacodyl

A

stimulant laxative

70
Q

what would you use for chornic constpiation

A

polyethylene glycol
mag hydroxide, mag citrate
mag sulfate
lactulose

71
Q

what would you take to reduce diarrhea

A

loperamide - activates opioids receptors

72
Q

what kind of drug is ondansetron

A

anti-emetic

serotonin antagonists

73
Q

how do you delivery ondansetron

A

slow!
fast push can cause QT prolongation and VT

74
Q

what are dopamine antagonists used for nausea

A

promethazine
chlorpromazine

75
Q

how often do you change TPN tubing and bag

A

q 24 hours

76
Q

if you run out of TPN, what do you give

A

dextrose 10% at same rate as TPN was running

77
Q

ae of furosemide

A

hyponatremia
hypochloremia
hypokalemia

ototoxicity

dehydration

78
Q

which drugs trigger beta cells to release insulin

A

sulfonylureas (glimepiride, glyburide)

79
Q

what kind of drug is metformin

A

biguanide

80
Q

what is rosiglitazone used for

A

reduces glucose production and increases insulin receptor sensitivity

81
Q

how does metformin work

A

inhibit liver glucose production and reduce intestinal absorption of glucose

82
Q

therapeutic aptt on heparin

A

1.5-2x normal

normal = 30-40 seconds

83
Q

heparin antidote

A

protamin sulfate

84
Q

door to TPA time

A

60 mins

85
Q

what is compatible with blood

A

normal saline

86
Q

when do you take vitals during blood admin

A

before
during
after

87
Q

what are augmentin and zosyn

A

beta lactamase inhibitors + antibiotics

88
Q

if you take valproate, what antibiotic should you avoid

A

carbapenems (i.e. meropenem)

89
Q

when do you use doxycycline

A

roxy mt spotted fever

chlamydia

cholera

lyme

anthrax

h. pylori

90
Q

what are nursing considerations for tetracyclines

A

teeth staining

photosensitivity

poorly absorbed when taken with minerals

91
Q

what do macrolide antibiotics end in

A

-mycin

92
Q

what do aminoglycoside anitbiotics end in

A

-icin

93
Q

side effects of aminoglycosides

A

ototoxic!

monitor for tinnitus

94
Q

when do we usually give sulfonamides

A

UTIs

95
Q

nursing considerations: sulfonamies

A

hypersensitivity reactions
blood dyscrasia
kernicterus (avoid in infants and later in pregnancy)
nephrotoxic (drink lots of water!)

96
Q

what organ does vancomycin affect

A

kidneys! it is nephrotoxic

97
Q

what are 2 drugs that work against TB

A

isoniazid
rifampin

98
Q

isoniazid nursing considerations

A

hepatoxicity
peripheral neuritis
can raise some levels of anti-seizure drugs

99
Q

what drug turns bodily fluids red-orange

A

rifampin

100
Q

what drugs does rifampin mess with

A

accelerates metabolism of HIV drugs

reduce effectiveness of OCs and warfarin

101
Q

why would you take amphotericin

A

systemic fungal infections

102
Q

nursing considerations for amphotericin

A

highly renal toxic
give with one liter of saline
IV only

103
Q

what is the longest acting benzo

A

diazepam

104
Q

what is the shortest acting benzo

A

midazolam

105
Q

side effects of TCAs

A

tachycardia
cardiac effects (prolonged QT)
anticholinergic effects
sedation/sexual dysfunction

106
Q

what should you avoid when administering lithium

A

no NSAIDS!

107
Q

5 nursing considerations of haloperidol

A

EPS

tardive dyskinesia

neuroleptic malignant syndrome

prolong QT

CT in pregnancy

108
Q

s/s of neuroleptic malignant syndrome

A

high fever
rigid muscles

109
Q

what 2 drugs are used as tocolytics

A

terbutaline
mag sulfate

110
Q

when can you give ibuprofen to a peds patient

A

not before 6 months d/t immature liver

111
Q

what is oseltmaivir

A

tamaflu

112
Q

in low doses where does epi work

A

beta 1

113
Q

in high doses where does epi work

A

beta 1 and alpha 1

114
Q

what receptors does norepi work on

A

alpha 1 leading to peripheral vasoconstriction
use for shock and hypotension

115
Q

when do we use dopamine in critical care

A

shock, hypotension, trauma
high doses cause vasoconstriction to increase BP

116
Q

what is third line in septic shock

A

vasopressin

116
Q

what will low doses of dopamine do

A

increase renal blood flow

117
Q

when is milrinone used

A

cardiogenic shock
decreased CO
congenital/acquired heart defects

when heart is not strong enough to maintain adequate cardiac output

118
Q

MOA of milrinone

A

phosphodiesterase inhibitor –> usually breaks down camp so inhibiting allows more cells of heart muscle to contract

119
Q

how often do you change IV tubing for a CVC

A

q 96 hours or per facility protocol

120
Q

how often do you do CVC dressing changes

A

weekly or more often
sterile!

121
Q

what pt position do you place and remove a CVC

A

trendelenburg

122
Q

how often do you change bag and tubing for TPN

A

q24 hours

123
Q

when is s3 heard

A

systolic HF

124
Q

when is s4 heard

A

diastolic HF

125
Q

where do you assess macewans sign

A

junction of the frontal, temporal, and parietal bones

126
Q

what 6 vaccines are given at 2 and 6 months

A

Dtap
rotavirus
ipv
pcv13
hep b
hib

Dripping in hep b and hib

127
Q

4 month vaccines

A

Dtap
rotavirus
ipv
pcv

hib

dripping in hib

128
Q

12 month vaccines

A

VAMP hib

varicella
hep A
MMR
pcv13

hib

129
Q

4-6 vaccines

A

MID v

MMR
IPV
Dtap

varicella

130
Q

when do you start getting annual flu shot

A

6 months

131
Q

what are the live vaccines

A

MMR
varicella
rotavirus
palivizumab (for RSV)

many vaccines ready to pounce!

132
Q

when does colorectal screening start

A

50+

133
Q

when is breast cancer screening started

A

> 40

134
Q

what family planning method increases risk for TSS

A

diaphragm

135
Q

what is ribavirin used for

A

to treat hep c

136
Q

can an LPN give rhogam

A

no - blood product

137
Q

do you need to take your blood sugar before taking metformin

A

no because it does not cause hypoglycemia!

138
Q

does calcitonin increase or decrease calcium levels

A

decrease

139
Q

what is Phenazopyridine

A

urinary tract analgesic

140
Q
A

NCLEX Prep (20 decks)

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